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Wang G, Tao L. Bilingual Language Control in the Brain: Evidence from Structural and Effective Functional Brain Connectivity. J Cogn Neurosci 2024; 36:836-853. [PMID: 38357989 DOI: 10.1162/jocn_a_02128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/16/2024]
Abstract
Experience in bilingual language control is often accompanied by changes in the structure and function of the brain. Brain structural changes are also often closely related to changes in functions. Previous studies, however, have not directly explored the relationship between structural connectivity and effective functional connectivity of the brain during bilingual language control, and whether the two types of connectivity are associated with behavioral performance of language control. Using behavioral performance, functional, and diffusion imaging techniques, we found that: (1) during language control, the left dorsal lateral prefrontal cortex (dlPFC), left caudate nucleus (CN), inferior parietal lobe, precuneus, and dorsal anterior cingulate cortex (dACC)/pre-SMA were significantly activated. (2) In the language control model with left dlPFC, dACC/pre-SMA, and left CN as ROIs (selected based on activation results and language control models from previous studies), stimuli first enter dACC/pre-SMA and then to left CN. At the left CN, a bidirectional effective connectivity is formed with left dlPFC. (3) There is a nonlinear relationship between effective connectivity during language control and the structural connectivity of the second language learners' brains. Specifically, the fiber density between dACC/pre-SMA and left dlPFC has a positive influence on the bidirectional effective connectivity between left dlPFC and left CN. Findings of the present study contribute evidence toward functional effective connectivity during bilingual language control; toward structural connectivity in the brains of second language learners; as well as toward nonlinear relationships between functional effective connectivity, structural connectivity, and behavioral performance in relation to bilingual language control.
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Affiliation(s)
- Gongting Wang
- East China Normal University
- Freie Universität Berlin
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2
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Dentella V, Masullo C, Leivada E. Bilingual disadvantages are systematically compensated by bilingual advantages across tasks and populations. Sci Rep 2024; 14:2107. [PMID: 38267616 PMCID: PMC10808122 DOI: 10.1038/s41598-024-52417-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Accepted: 01/18/2024] [Indexed: 01/26/2024] Open
Abstract
Bilingualism is linked to both enhanced and hampered performance in various cognitive measures, yet the extent to which these bilingual advantages and disadvantages co-occur is unclear. To address this gap, we perform a systematic review and two quantitative analyses. First, we analyze results from 39 studies, obtained through the PRISMA method. Less than 50% of the studies that show up as results for the term "bilingual disadvantage" report exclusively a disadvantage, that shows bilinguals performing worse than monolinguals in a task. A Bayesian analysis reveals robust evidence for bilingual effects, but no evidence for differences in the proportion of advantages and disadvantages, suggesting that when results from different cognitive domains such as executive functions and verbal fluency are analyzed together, bilingual effects amount to a zero-sum game. This finding was replicated by repeating the analysis, using the datasets of two recent meta-analyses. We propose that the equilibrium we observe between positive and negative outcomes may not be accidental. Contrary to widespread belief, advantageous and disadvantageous effects are not stand-alone outcomes in free variation. We reframe them as the connatural components of a dynamic trade-off, whereby enhanced performance in one cognitive measure is offset by an incurred cost in another domain.
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Affiliation(s)
- Vittoria Dentella
- Department of English and German Studies, Universitat Rovira i Virgili, Tarragona, Spain.
| | - Camilla Masullo
- Department of English and German Studies, Universitat Rovira i Virgili, Tarragona, Spain
| | - Evelina Leivada
- Department of Catalan Philology, Universitat Autònoma de Barcelona, Barcelona, Spain
- Institució Catalana de Recerca i Estudis Avançats (ICREA), Barcelona, Spain
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3
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Meltzer JA, Kates Rose M, Le AY, Spencer KA, Goldstein L, Gubanova A, Lai AC, Yossofzai M, Armstrong SEM, Bialystok E. Improvement in executive function for older adults through smartphone apps: a randomized clinical trial comparing language learning and brain training. NEUROPSYCHOLOGY, DEVELOPMENT, AND COGNITION. SECTION B, AGING, NEUROPSYCHOLOGY AND COGNITION 2023; 30:150-171. [PMID: 34694201 DOI: 10.1080/13825585.2021.1991262] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
Bilingualism has been linked to improved executive function and delayed onset of dementia, but it is unknown whether similar benefits can be obtained later in life through deliberate intervention. Given the logistical hurdles of second language acquisition in a randomized trial for older adults, few interventional studies have been done thus far. However, recently developed smartphone apps offer a convenient means to acquire skills in a second language and can be compared with brain training apps specifically designed to improve executive function. In a randomized clinical trial, 76 adults aged 65-75 were assigned to either 16 weeks of Spanish learning using the app Duolingo 30 minutes a day, an equivalent amount of brain training using the app BrainHQ, or a waitlist control condition. Executive function was assessed before and after the intervention with preregistered (NCT03638882) tests previously linked to better performance in bilinguals. For two of the primary measures: incongruent Stroop color naming and 2-back accuracy, Duolingo provided equivalent benefits as BrainHQ compared to a control group. On reaction time for N-back and Simon tests, the BrainHQ group alone experienced strong gains over the other two groups. Duolingo was rated as more enjoyable. These results suggest that app-based language learning may provide some similar benefits as brain training in improving executive function in seniors but has less impact on processing speed. However, future advancements in app design may optimize not only the acquisition of the target language but also the side benefits of the language learning experience.
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Affiliation(s)
- Jed A Meltzer
- Baycrest Health Sciences, Rotman Research Institute, Toronto ON, Canada.,Department of Psychology, University of Toronto, Toronto ON, Canada.,Department of Speech-Language Pathology, University of Toronto, Toronto ON, Canada.,Canadian Partnership for Stroke Recovery, Ottawa ON, Canada
| | - Mira Kates Rose
- Baycrest Health Sciences, Rotman Research Institute, Toronto ON, Canada
| | - Anna Y Le
- Baycrest Health Sciences, Rotman Research Institute, Toronto ON, Canada
| | - Kiah A Spencer
- Baycrest Health Sciences, Rotman Research Institute, Toronto ON, Canada
| | - Leora Goldstein
- Baycrest Health Sciences, Rotman Research Institute, Toronto ON, Canada
| | - Alina Gubanova
- Baycrest Health Sciences, Rotman Research Institute, Toronto ON, Canada
| | - Abbie C Lai
- Baycrest Health Sciences, Rotman Research Institute, Toronto ON, Canada
| | - Maryam Yossofzai
- Baycrest Health Sciences, Rotman Research Institute, Toronto ON, Canada
| | | | - Ellen Bialystok
- Baycrest Health Sciences, Rotman Research Institute, Toronto ON, Canada.,Department of Psychology, York University, Toronto ON, Canada
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Giovannoli J, Martella D, Casagrande M. Executive functioning during verbal fluency tasks in bilinguals: A systematic review. INTERNATIONAL JOURNAL OF LANGUAGE & COMMUNICATION DISORDERS 2023. [PMID: 36748790 DOI: 10.1111/1460-6984.12855] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/23/2021] [Accepted: 01/11/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND Bilingualism is widespread and being bilingual is more common than being monolingual. The lifelong practice bilinguals receive from managing two languages seems to lead to a cognitive benefit. Conversely, bilingualism seems to affect language ability negatively due to less use of each known language. AIMS This systematic review aims to summarize the results of the studies on the effect of bilingualism on executive functioning assessed by verbal fluency tasks. The verbal fluency task is a neuropsychological measure of lexical retrieval efficiency and executive functioning. METHODS The review was conducted according to the PRISMA statement through searches in the scientific databases PsycINFO, PsycARTICLES, MEDLINE, PubMed, Web of Science and SCOPUS. Studies included in this review had at least one bilingual and monolingual group, participants over 18 years and one verbal fluency task. Studies that considered bimodal bilingual, second language learners, trilingual or multilingual people, and clinical populations were excluded. A total of 38 studies were included in the systematic review. MAIN CONTRIBUTION Quantitative analysis of performance did not show significant differences between monolinguals and bilinguals. Qualitative results are mixed, and no definitive conclusions can be drawn about a bilingual advantage or disadvantage in the verbal fluency tasks. CONCLUSIONS Normative data based on the monolingual population are not appropriate to test a bilingual population. It is necessary to take precautions in using this task, especially in clinical practice. WHAT THIS PAPER ADDS What is already known on the subject Bilingualism seems to lead to a cognitive benefit due to constantly monitoring the known languages to select the most suitable one for each interactional context and to affect language ability negatively due to less use of each known language but also to language ability negatively. What this paper adds to the existing knowledge This systematic review summarizes the results of the studies on the effect of bilingualism on executive functioning assessed by verbal fluency tasks, a neuropsychological measure of lexical retrieval efficiency and executive functioning. What are the potential or actual clinical implications of this work? Normative data based on the monolingual population are not appropriate to test a bilingual population. It is necessary to take precautions in using this task, especially in clinical practice.
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Affiliation(s)
- Jasmine Giovannoli
- Dipartimento di Psicologia, Università degli Studi di Roma 'La Sapienza', Rome, Italy
| | - Diana Martella
- Departamento de Psicología, Facultad de Ciencias sociales y humanas, Universidad Loyola Andalucía, Dos Hermanas Seville, España
| | - Maria Casagrande
- Dipartimento di Psicologia Dinamica, Clinica e Salute, Università degli Studi di Roma 'La Sapienza', Rome, Italy
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Carthery-Goulart MT, Privitera AJ, Weekes BS. Does Language Distance Modulate the Contribution of Bilingualism to Cognitive Reserve in Seniors? A Systematic Review. Am J Alzheimers Dis Other Demen 2023; 38:15333175231167223. [PMID: 37186676 PMCID: PMC10623985 DOI: 10.1177/15333175231167223] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/17/2023]
Abstract
We report a systematic review and exploratory meta-regression investigating the hypothesis that the effects of bilingualism on cognitive reserve are modulated by the distance between the pair of languages a bilingual uses. An inclusive multiple database search was performed in order to identify all relevant published research conducted in bilingual seniors. A combination of qualitative and quantitative synthesis methods were used in order to investigate our research questions. Results suggest that healthy bilingual seniors speaking more distant language pairs show improved monitoring performance on cognitive tasks. Evidence regarding a modulatory influence of language distance (LD) on the age of dementia diagnosis was inconclusive due to the small number of published studies meeting our inclusion criteria. We recommend more detailed reporting of individual differences in bilingual experience to assess the impact of LD and other variables on typical cognitive aging and the development of dementia. Linguistic differences in samples should also be considered as a constraint on bilingual advantages in future studies. Preregistration: PROSPERO CRD42021238705; OSF DOI 10.17605/OSF.IO/VPRBU.
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Affiliation(s)
- Maria Teresa Carthery-Goulart
- Faculty of Education, University of Hong Kong, Hong Kong
- Center for Mathematics, Computing and Cognition, Federal University of ABC, Sao Paulo, Brazil
- Behavioral and Cognitive Neurology Unit, Department of Neurology, Hospital Das Clínicas, University of São Paulo, SP, Brazil
| | - Adam John Privitera
- Faculty of Education, University of Hong Kong, Hong Kong
- Centre for Research and Development in Learning, Nanyang Technological University, Singapore
| | - Brendan Stuart Weekes
- Faculty of Education, University of Hong Kong, Hong Kong
- Department of Psychology, University of Cambridge, Cambridge, UK
- School of Psychology, University of Melbourne, Melbourne, VIA, Australia
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6
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Mendez MF. Can Speaking More Than One Language Help Prevent Alzheimer's Disease? J Alzheimers Dis 2023; 95:363-377. [PMID: 37545240 DOI: 10.3233/jad-230285] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/08/2023]
Abstract
Alzheimer's disease (AD) is an age-related neurocognitive disorder that is epidemic in the elderly population. Currently, there are limited pharmacological interventions, and this has heightened the urgency to identify potential preventable or modifiable risk factors that promote resilience to the neuropathological effects of AD. The regular use of two or more languages is one such factor that may increases cognitive reserve through the long-standing executive control involved in managing multiple languages in the brain. There is also evidence that bilingualism is associated with increased brain reserve or maintenance, particularly in frontal-executive structures and networks. This review examines the current, sometimes conflicting literature on bi/multilingualism and AD. These studies have confounding variations in the assessment of age of second language onset, language proficiency, language usage, and whether determining incidence of AD or age of symptom onset. Despite these limitations, most publications support the presence of increased frontal-executive reserve that compensates for the development of AD neuropathology and, thereby, delays the emergence of clinical symptoms of dementia by about 4-5 years. Although regularly speaking more than one language does not protect against AD neuropathology, the delay in its clinical expression has a potentially significant impact on the lifelong morbidity from this age-related disease. Learning other languages may be an important modifiable factor for delaying the clinical expression of AD in later life.
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Affiliation(s)
- Mario F Mendez
- Departments of Neurology and Psychiatry & Biobehavioral Sciences, David Geffen School of Medicine, University of California, Los Angeles, and Neurology Service, Neurobehavior Unit, U.S. Department of Veterans Affairs Greater Los Angeles Healthcare System, Los Angeles, CA, USA
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Quiroz YT, Solis M, Aranda MP, Arbaje AI, Arroyo‐Miranda M, Cabrera LY, Carrasquillo MM, Corrada MM, Crivelli L, Diminich ED, Dorsman KA, Gonzales M, González HM, Gonzalez‐Seda AL, Grinberg LT, Guerrero LR, Hill CV, Jimenez‐Velazquez IZ, Guerra JJL, Lopera F, Maestre G, Medina LD, O'Bryant S, Peñaloza C, Pinzon MM, Mavarez RVP, Pluim CF, Raman R, Rascovsky K, Rentz DM, Reyes Y, Rosselli M, Tansey MG, Vila‐Castelar C, Zuelsdorff M, Carrillo M, Sexton C. Addressing the disparities in dementia risk, early detection and care in Latino populations: Highlights from the second Latinos & Alzheimer's Symposium. Alzheimers Dement 2022; 18:1677-1686. [PMID: 35199931 PMCID: PMC9399296 DOI: 10.1002/alz.12589] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2021] [Revised: 12/20/2021] [Accepted: 12/21/2021] [Indexed: 02/05/2023]
Abstract
The Alzheimer's Association hosted the second Latinos & Alzheimer's Symposium in May 2021. Due to the COVID-19 pandemic, the meeting was held online over 2 days, with virtual presentations, discussions, mentoring sessions, and posters. The Latino population in the United States is projected to have the steepest increase in Alzheimer's disease (AD) in the next 40 years, compared to other ethnic groups. Latinos have increased risk for AD and other dementias, limited access to quality care, and are severely underrepresented in AD and dementia research and clinical trials. The symposium highlighted developments in AD research with Latino populations, including advances in AD biomarkers, and novel cognitive assessments for Spanish-speaking populations, as well as the need to effectively recruit and retain Latinos in clinical research, and how best to deliver health-care services and to aid caregivers of Latinos living with AD.
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Affiliation(s)
- Yakeel T. Quiroz
- Harvard Medical SchoolMassachusetts General HospitalBostonMassachusettsUSA
| | | | | | - Alicia I. Arbaje
- Division of Geriatric Medicine and GerontologyJohns Hopkins School of MedicineBaltimoreMarylandUSA
- Department of Health Policy and ManagementJohns Hopkins Bloomberg School of Public HealthBaltimoreMarylandUSA
| | | | - Laura Y. Cabrera
- The Pennsylvania State UniversityDepartment of Engineering Science and MechanicsUniversity ParkPennsylvaniaUSA
| | | | | | - Lucia Crivelli
- FleniDepartment of Cognitive NeurologyBuenos AiresArgentina
| | | | | | - Mitzi Gonzales
- The University of Texas Health Science Center at San AntonioSan AntonioTexasUSA
| | - Héctor M. González
- Department of NeurosciencesUniversity of California, San DiegoSan DiegoCaliforniaUSA
| | | | - Lea T. Grinberg
- University of California, San FranciscoSan FranciscoCaliforniaUSA
| | - Lourdes R. Guerrero
- David Geffen School of Medicine at University of California, Los AngelesLos AngelesCaliforniaUSA
| | | | - Ivonne Z. Jimenez‐Velazquez
- Medicine DepartmentUniversity of Puerto Rico School of MedicineMedical Sciences CampusSan JuanPuerto RicoUSA
| | | | - Francisco Lopera
- Neuroscience Group of AntioquiaUniversity of AntioquiaMedellinColombia
| | | | | | - Sid O'Bryant
- University of North Texas Health Science CenterFort WorthTexasUSA
| | - Claudia Peñaloza
- Department of CognitionDevelopment and Educational PsychologyUniversity of BarcelonaBarcelonaSpain
| | - Maria Mora Pinzon
- Department of Family Medicine and Community HealthUniversity of Wisconsin–MadisonMadisonWisconsinUSA
- Wisconsin Alzheimer's InstituteUniversity of Wisconsin–MadisonMadisonWisconsinUSA
| | - Rosa V. Pirela Mavarez
- University of Texas Rio Grande ValleySchool of Medicine, Department of Human GeneticsEdinburgTexasUSA
- Rio Grande Valley Alzheimer's Disease Resources Center for Minority Aging ResearchUniversity of Texas Rio Grande ValleySchool of MedicineEdinburgTexasUSA
| | - Celina F. Pluim
- Harvard Medical SchoolMassachusetts General HospitalBostonMassachusettsUSA
| | - Rema Raman
- Alzheimer's Therapeutic Research InstituteUniversity of Southern CaliforniaSan DiegoCaliforniaUSA
| | - Katya Rascovsky
- Department of NeurologyUniversity of PennsylvaniaPhiladelphiaPennsylvaniaUSA
| | | | | | - Monica Rosselli
- Department of PsychologyFlorida Atlantic UniversityBoca RatonFloridaUSA
| | | | | | - Megan Zuelsdorff
- University of Wisconsin–Madison School of NursingMadisonWisconsinUSA
- Wisconsin Alzheimer's Disease Research CenterMadisonWisconsinUSA
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8
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Chen S, Lin Y, Zuo S, Wang Z, Liang J, Jiang Z, Xu Y, Wang P, Jing X, Lin L. Cognitive Advantage of Bilingualism Over Monolingualism in Older Adults: A Meta-Analysis. Curr Alzheimer Res 2022; 19:555-567. [PMID: 36125836 DOI: 10.2174/1567205019666220920092234] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2022] [Revised: 08/18/2022] [Accepted: 08/22/2022] [Indexed: 01/27/2023]
Abstract
OBJECTIVES This study aimed to explore whether bilingual older adults had a cognitive advantage over their monolingual counterparts, and validate the influence of cognition-related (participants' cognitive condition, the cognitive domain assessed), and bilingualism-related factors (second language proficiency, frequency of use, acquisition time, and immigration status of participants)on the cognitive advantage of bilingualism. METHODS Through a systematic search of nine databases (Web of Science, PubMed, Elsevier Science Direct, Cochrane Library, Embase, PsycINFO, CNKI, VIP and Wanfang) from the inception to April 2021, observational studies with bilingual and monolingual older adults as participants and cognitive function scores as outcome measures were included. Two reviewers independently completed the selection and methodological quality assessment of studies using the JBI cross-sectional study quality evaluation tool and used a pre-designed table for data extraction and sorting. RESULTS Fourteen studies with 51 tasks were included, involving 3737 participants (bilingual group: 1695, monolingual group: 2042). The overall results of the meta-analysis showed that bilingualism had a small cognitive advantage over monolingualism in older adults [SMD=0.23, 95%CI (0.07, 0.38), P=0.004]. In addition, the subgroup analyses indicated that factors such as participants' cognitive condition, the cognitive domain assessed, second language proficiency, acquisition time, and immigration status of participants impacted the cognitive advantage of bilingualism in older adults. CONCLUSION Bilingualism had a mild cognitive advantage over monolingualism in older adults, which was more prominent in older adults with mild cognitive impairment than in cognitively healthy ones, more evident in global cognitive function and inhibitory control than in other individual cognitive domains, and might be influenced by the proficiency and acquisition time of second language as well as the immigration status of older adults.
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Affiliation(s)
- Si Chen
- The First Affiliated Hospital of Soochow University, Suzhou 215006, China.,School of Nursing, Medical College of Soochow University, Suzhou 215006, China
| | - Yuying Lin
- The First Affiliated Hospital of Soochow University, Suzhou 215006, China.,School of Nursing, Medical College of Soochow University, Suzhou 215006, China
| | - Shufang Zuo
- School of Nursing, Medical College of Soochow University, Suzhou 215006, China
| | - Ziyu Wang
- School of Nursing, Medical College of Soochow University, Suzhou 215006, China
| | - Jinghong Liang
- Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China
| | - Zheng Jiang
- School of Nursing, Medical College of Soochow University, Suzhou 215006, China
| | - Yue Xu
- School of Nursing, Medical College of Soochow University, Suzhou 215006, China
| | - Peiyu Wang
- School of Nursing, Medical College of Soochow University, Suzhou 215006, China
| | - Xiuchen Jing
- School of Nursing, Medical College of Soochow University, Suzhou 215006, China
| | - Lu Lin
- The First Affiliated Hospital of Soochow University, Suzhou 215006, China.,School of Nursing, Medical College of Soochow University, Suzhou 215006, China
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Needs, issues, and expectations on dementia care at home across Europe to inform policy development: Findings from a transnational research study. Health Policy 2021; 125:1013-1022. [PMID: 34210512 DOI: 10.1016/j.healthpol.2021.05.012] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2020] [Revised: 05/11/2021] [Accepted: 05/20/2021] [Indexed: 01/02/2023]
Abstract
This qualitative descriptive study explored needs, issues, and expectations on dementia care at home as expressed by relatives of people living with dementia (PwD), health and social care professionals (HSCPs), and members of civil society organisations (CSOs) from four European countries. A focus group methodology integrated with individual semi-structured interviews was adopted to collect data by employing a purposeful sampling method. A total of 13 focus groups and 12 individual interviews were conducted in 2019, involving 65 relatives of PwD, 32 HSCPs, and 23 members of CSOs. Deductive content analysis and findings triangulation were performed to analyse data, and a subgroup of participants confirmed the findings. Relatives need to be (a) informed and trained to cope with changes in PwD, (b) recognised for their caregiving role, and (c) assisted by specialised HSCPs. Professionals who work in partnership with PwD and their relatives call for a reorganisation of available services. CSOs compensate for the lack of proper support, promoting networks, and cooperation with local communities. Several commonalities emerged across countries, highlighting the chance to inform and develop common policies to improve the quality of life of PwD and their relatives across Europe. Policies improving person- and family-centred care and spreading dementia-friendly community concepts and practices are suggested. Strong collaborations between formal and informal services and communities are also needed as well as information on educational strategies to improve the use of resources, promote PwD care, and support PwD relatives' needs.
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Briceño EM, Mehdipanah R, Gonzales XF, Heeringa SG, Levine DA, Langa KM, Zahs D, Garcia N, Longoria R, Morgenstern LB. Bilingualism, assessment language, and the Montreal Cognitive Assessment in Mexican Americans. J Am Geriatr Soc 2021; 69:1971-1981. [PMID: 33963535 DOI: 10.1111/jgs.17209] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Revised: 03/19/2021] [Accepted: 04/11/2021] [Indexed: 12/24/2022]
Abstract
BACKGROUND/OBJECTIVES Assessment of cognition in linguistically diverse aging populations is a growing need. Bilingualism may complicate cognitive measurement precision, and bilingualism may vary across Hispanic/Latinx sub-populations. We examined the association among bilingualism, assessment language, and cognitive screening performance in a primarily non-immigrant Mexican American community. DESIGN Prospective, community-based cohort study: The Brain Attack Surveillance in Corpus Christi (BASIC)-Cognitive study. SETTING Nueces County, Texas. PARTICIPANTS Community-dwelling Mexican Americans age 65+, recruited door-to-door using a two-stage area probability sampling procedure. MEASUREMENTS Montreal Cognitive Assessment (MoCA); self-reported bilingualism scale. Participants were classified as monolingual, Spanish dominant bilingual, English dominant bilingual, or balanced bilingual based upon bilingualism scale responses. Linear regressions examined relationships among bilingualism, demographics, cognitive assessment language, and MoCA scores. RESULTS The analytic sample included 547 Mexican American participants (60% female). Fifty-eight percent were classified as balanced bilingual, the majority (88.6%) of whom selected assessment in English. Balanced bilinguals that completed the MoCA in English performed better than balanced bilinguals that completed the MoCA in Spanish (b = -4.0, p < 0.05). Among balanced bilinguals that took the MoCA in Spanish, education outside of the United States was associated with better performance (b = 4.4, p < 0.001). Adjusting for demographics and education, we found no association between the degree of bilingualism and MoCA performance (p's > 0.10). CONCLUSION Bilingualism is important to consider in cognitive aging studies in linguistically diverse communities. Future research should examine whether cognitive test language selection affects cognitive measurement precision in balanced bilinguals.
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Affiliation(s)
- Emily M Briceño
- Department of Physical Medicine & Rehabilitation, University of Michigan Medical School, Ann Arbor, Michigan, USA.,Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor, Michigan, USA
| | - Roshanak Mehdipanah
- Department of Health Behavior and Health Education, School of Public Health, University of Michigan, Ann Arbor, Michigan, USA
| | - Xavier F Gonzales
- Department of Life Sciences, Texas A&M University-Corpus Christi, Corpus Christi, Texas, USA
| | - Steven G Heeringa
- Institute for Social Research, University of Michigan, Ann Arbor, Michigan, USA
| | - Deborah A Levine
- Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor, Michigan, USA.,Department of Internal Medicine, University of Michigan Medical School, Ann Arbor, Michigan, USA
| | - Kenneth M Langa
- Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor, Michigan, USA.,Institute for Social Research, University of Michigan, Ann Arbor, Michigan, USA.,Department of Internal Medicine, University of Michigan Medical School, Ann Arbor, Michigan, USA.,VA Ann Arbor Healthcare System, Veterans Affairs Center for Clinical Management Research, Ann Arbor, Michigan, USA
| | - Daniel Zahs
- Institute for Social Research, University of Michigan, Ann Arbor, Michigan, USA
| | - Nelda Garcia
- Department of Neurology, University of Michigan Medical School, Ann Arbor, Michigan, USA
| | - Ruth Longoria
- Department of Neurology, University of Michigan Medical School, Ann Arbor, Michigan, USA
| | - Lewis B Morgenstern
- Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor, Michigan, USA.,Department of Neurology, University of Michigan Medical School, Ann Arbor, Michigan, USA.,Center for Social Epidemiology and Population Health, School of Public Health, University of Michigan, Ann Arbor, Michigan, USA
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11
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Nijmeijer SE, van Tol MJ, Aleman A, Keijzer M. Foreign Language Learning as Cognitive Training to Prevent Old Age Disorders? Protocol of a Randomized Controlled Trial of Language Training vs. Musical Training and Social Interaction in Elderly With Subjective Cognitive Decline. Front Aging Neurosci 2021; 13:550180. [PMID: 33986653 PMCID: PMC8111015 DOI: 10.3389/fnagi.2021.550180] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2020] [Accepted: 03/29/2021] [Indexed: 11/13/2022] Open
Abstract
Introduction: With aging comes a reduction of cognitive flexibility, which has been related to the development of late-life depression and progression of general cognitive decline. Several factors have been linked to attenuating such decline in cognitive flexibility, such as education, physical exercise and stimulating leisure activities. Speaking two or more languages has recently received abundant attention as another factor that may build up cognitive reserve, thereby limiting the functional implications of compromised cognition that accompany old age. With the number of older adults reaching record levels, it is important to attenuate the development of old-age disorders. Learning to speak a foreign language might offer a powerful tool in promoting healthy aging, but up to date effect studies are sparse. Here, the protocol that forms the foundation of the current study is presented. The present study aims to: (1) examine the effects of a foreign language training on cognitive flexibility and its neural underpinnings, and on mental health; and (2) assess the unique role of foreign language training vs. other cognitive or social programs. Method: One-hundred and ninety-eight Dutch elderly participants reporting subjective cognitive decline are included and randomized to either a language intervention, a music intervention, or a social control intervention. During 3 to 6 months, the language group learns English, the music group learns to play the guitar and the social group participates in social meetings where art workshops are offered. At baseline, at a 3-month follow-up, and at 6 months after termination of the training program, clinical, cognitive and brain activity measurements (combined EEG and fNIRS methods) are taken to assess cognitive flexibility and mental health. Discussion: This is the first trial addressing combined effects of language learning in elderly on cognition, language proficiency, socio-affective measures, and brain activity in the context of a randomized controlled trial. If successful, this study can provide insights into how foreign language training can contribute to more cognitively and mentally healthy years in older adulthood. Clinical Trial Registration: The trial is registered at the Netherlands Trial Register, July 2, 2018, trial number NL7137. https://www.trialregister.nl/trial/7137.
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Affiliation(s)
- Saskia E. Nijmeijer
- Cognitive Neuroscience Center, Department of Biomedical Sciences of Cells and Systems, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
| | - Marie-José van Tol
- Cognitive Neuroscience Center, Department of Biomedical Sciences of Cells and Systems, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
| | - André Aleman
- Cognitive Neuroscience Center, Department of Biomedical Sciences of Cells and Systems, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
| | - Merel Keijzer
- English Linguistics and English as a Second Language, Bilingualism and Aging Lab, University of Groningen, Groningen, Netherlands
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Fishman KN, Roberts AC, Orange JB, Sunderland KM, Marras C, Tan B, Steeves T, Kwan D, Lang AE, Grimes D, Levine B, Masellis M, Binns MA, Jog M, Strother SC, Investigators O, McLaughlin PM, Troyer AK. Bilingualism in Parkinson's disease: Relationship to cognition and quality of life. J Clin Exp Neuropsychol 2021; 43:199-212. [PMID: 33827353 DOI: 10.1080/13803395.2021.1902946] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Some studies have found that bilingualism promotes cognitive reserve. OBJECTIVE We aimed to determine whether bilingualism, defined as regularly (i.e. daily) using at least two languages at least since early adulthood, is associated with cognitive advantages in Parkinson's disease (PD) or whether the possible benefits of bilingualism are lost in the context of PD, possibly affecting quality of life (QoL) and independence. METHOD Participants with idiopathic PD (n = 140, mean age = 67.9 [SD = 6.4], 78% men) completed standard neuropsychological tasks evaluating attention/working memory, language, executive function, memory, and visuospatial ability, as well as measures of wellbeing and functional independence. RESULTS Bilinguals with PD (n = 21) performed worse than monolinguals with PD (n = 92) on attention/working memory and language measures. The between-group differences in attention/working memory were restricted to verbally-based measures. When measured along a continuum, a higher degree of bilingualism was correlated with lower scores on measures of attention/working memory and language. There were no group differences in self- or informant-reported cognitive decline, PD health-related QoL, or functional independence. CONCLUSIONS Bilingualism in PD was not associated with better cognitive performance. Lower scores on language-based measures may reflect a distributed fund of linguistic information across more than one language, lower language proficiency in English, and/or other cultural artifacts. Furthermore, using normative data specific to the dominant language spoken or conducting neuropsychological testing in participants' self-reported most proficient language may enhance additional studies addressing this topic. Future research may also examine the roles of bilingualism over time and across other neurodegenerative diseases with and without EF impairment to illuminate further the impact of bilingualism on cognition and QoL, and shape culturally and linguistically diverse research and clinical care.
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Affiliation(s)
- Keera N Fishman
- University of Ottawa, Ottawa, Ontario, Canada.,Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
| | - Angela C Roberts
- Northwestern University, Evanston, Illinois, USA.,, Western University, London, Ontario, Canada
| | - J B Orange
- , Western University, London, Ontario, Canada
| | | | - Connie Marras
- , University of Toronto, Toronto, Ontario, Canada.,Toronto Western Hospital, Toronto, Ontario, Canada
| | - Brian Tan
- Baycrest Health Sciences, Toronto, Ontario, Canada
| | | | - Donna Kwan
- Queen's University, Toronto, Ontario, Canada
| | - Anthony E Lang
- , University of Toronto, Toronto, Ontario, Canada.,Toronto Western Hospital, Toronto, Ontario, Canada
| | - David Grimes
- University of Ottawa, Ottawa, Ontario, Canada.,The Ottawa Hospital, Ottawa, Ontario, Canada
| | - Brian Levine
- Baycrest Health Sciences, Toronto, Ontario, Canada.,, University of Toronto, Toronto, Ontario, Canada
| | - Mario Masellis
- Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
| | - Malcolm A Binns
- Baycrest Health Sciences, Toronto, Ontario, Canada.,, University of Toronto, Toronto, Ontario, Canada
| | - Mandar Jog
- , Western University, London, Ontario, Canada
| | - Stephen C Strother
- Baycrest Health Sciences, Toronto, Ontario, Canada.,, University of Toronto, Toronto, Ontario, Canada
| | | | - Paula M McLaughlin
- Queen's University, Toronto, Ontario, Canada.,Nova Scotia Health Authority, Halifax, Nova Scotia, Canada
| | - Angela K Troyer
- Baycrest Health Sciences, Toronto, Ontario, Canada.,, University of Toronto, Toronto, Ontario, Canada
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13
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Jones SK, Davies-Thompson J, Tree J. Can Machines Find the Bilingual Advantage? Machine Learning Algorithms Find No Evidence to Differentiate Between Lifelong Bilingual and Monolingual Cognitive Profiles. Front Hum Neurosci 2021; 15:621772. [PMID: 33828469 PMCID: PMC8019743 DOI: 10.3389/fnhum.2021.621772] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2020] [Accepted: 01/22/2021] [Indexed: 11/13/2022] Open
Abstract
Bilingualism has been identified as a potential cognitive factor linked to delayed onset of dementia as well as boosting executive functions in healthy individuals. However, more recently, this claim has been called into question following several failed replications. It remains unclear whether these contradictory findings reflect how bilingualism is defined between studies, or methodological limitations when measuring the bilingual effect. One key issue is that despite the claims that bilingualism yields general protection to cognitive processes (i.e., the cognitive reserve hypothesis), studies reporting putative bilingual differences are often focused on domain specific experimental paradigms. This study chose a broader approach, by considering the consequences of bilingualism on a wide range of cognitive functions within individuals. We utilised 19 measures of different cognitive functions commonly associated with bilingual effects, to form a "cognitive profile" for 215 non-clinical participants. We recruited Welsh speakers, who as a group of bilinguals were highly homogeneous, as means of isolating the bilingualism criterion. We sought to determine if such analyses would independently classify bilingual/monolingual participant groups based on emergent patterns driven by collected cognitive profiles, such that population differences would emerge. Multiple predictive models were trained to independently recognise the cognitive profiles of bilinguals, older adults (60-90 years of age) and higher education attainment. Despite managing to successfully classify cognitive profiles based on age and education, the model failed to differentiate between bilingual and monolingual cognitive ability at a rate greater than that of chance. Repeated modelling using alternative definitions of bilingualism, and just the older adults, yielded similar results. In all cases then, using our "bottom-up" analytical approach, there was no evidence that bilingualism as a variable indicated differential cognitive performance - as a consequence, we conclude that bilinguals are not cognitively different from their monolingual counterparts, even in older demographics. We suggest that studies that have reported a bilingual advantage (typically recruiting immigrant populations) could well have confounded other key variables that may be driving reported advantages. We recommend that future research refine the machine learning methods used in this study to further investigate the complex relationship between bilingualism and cognition.
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Affiliation(s)
- Samuel Kyle Jones
- Department of Psychology, Swansea University, Swansea, United Kingdom
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14
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Abstract
Evidence suggests that bilingualism may contribute to neuroplasticity and cognitive reserve, allowing individuals to resist cognitive decline associated with Alzheimer's disease progression, although the idea remains controversial. Here, we argue that the reason for the discrepancy stems from conflating incidence rates of dementia and the age at which the symptoms first appear, as well as statistical and methodological issues in the study designs. To clarify the issues, we conducted a comprehensive meta-analysis on the available literature regarding bilingualism and Alzheimer's disease, including both retrospective and prospective studies, as well as age of onset and incidence rates. Results revealed a moderate effect size for the protective effect of bilingualism on age of onset of symptoms of Alzheimer's disease (Cohen's d = 0.32), and weaker evidence that bilingualism prevents the occurrence of disease incidence itself (Cohen's d = 0.10). Moreover, our results cannot be explained by SES, education, or publication bias. We conclude with a discussion on how bilingualism contributes to cognitive reserve and protects against Alzheimer's disease and recommend that future studies report both age of onset as well as incidence rates when possible.
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15
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Campanella F, Arcara G, Crescentini C, Fabbro F, Skrap M. Cognitive reserve protects language functions in patients with brain tumours. Neuropsychologia 2021; 154:107769. [PMID: 33524456 DOI: 10.1016/j.neuropsychologia.2021.107769] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2020] [Revised: 01/25/2021] [Accepted: 01/26/2021] [Indexed: 12/26/2022]
Abstract
Cognitive reserve (CR) theory suggests that individual differences in general intelligence (IQ), occupational attainment or participation in leisure/recreational activities protect against cognitive decline. However the relationship between CR and cognitive functioning in patients with brain tumours has been very rarely investigated in past research. The present study systematically assesses whether CR concept can also be applied to cognitive functions of neurosurgical patients affected by brain tumours. We investigated the role of different CR proxies (education level, premorbid IQ, current IQ, working and leisure activity) in protecting language against brain tumours and surgery effects, considering interactions with demographic (sex/age), anatomical (hemisphere/lobe location of lesion) and clinical/biological variables (tumour type: High/Low Grade Glioma or Meningioma; lesion volume; lesion aggressiveness). One-hundred patients undergoing neuropsychological assessment before and immediately after surgery participated. A "Language Score" summarizing performance on all language tests was derived with Principal Component Analysis. Data were then analyzed with Multiple Regression and Classification and Regression Tree analyses to investigate possible relationships between predictors (CR proxies and clinical variables) and Language Score. We found that premorbid IQ was the best predictor of pre-operatory language integrity, above and beyond all clinical variables considered, also moderating lesion volume effects. Moreover, patients with lower pre-operatory language integrity and low-to-moderately aggressive tumours showed a mitigating effect of current IQ over surgery consequences. Results thus suggest that different CR proxies play a role in moderating cognitive decline following brain tumours and surgery.
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Affiliation(s)
- Fabio Campanella
- Neurosurgery Unit, Presidio Ospedaliero Universitario "S. Maria Della Misericordia", Udine, Italy; Cognitive Neuroscience Laboratory, DILL, University of Udine, Udine, Italy.
| | | | | | - Franco Fabbro
- Cognitive Neuroscience Laboratory, DILL, University of Udine, Udine, Italy; PERCRO Perceptual Robotics Laboratory, Scuola Superiore Sant'Anna, Pisa, Italy
| | - Miran Skrap
- Neurosurgery Unit, Presidio Ospedaliero Universitario "S. Maria Della Misericordia", Udine, Italy
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Rieker JA, Reales JM, Ballesteros S. The Effect of Bilingualism on Cue-Based vs. Memory-Based Task Switching in Older Adults. Front Hum Neurosci 2021; 14:610548. [PMID: 33390921 PMCID: PMC7775305 DOI: 10.3389/fnhum.2020.610548] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2020] [Accepted: 11/27/2020] [Indexed: 11/13/2022] Open
Abstract
Findings suggest a positive impact of bilingualism on cognition, including the later onset of dementia. However, it is not clear to what extent these effects are influenced by variations in attentional control demands in response to specific task requirements. In this study, 20 bilingual and 20 monolingual older adults performed a task-switching task under explicit task-cuing vs. memory-based switching conditions. In the cued condition, task switches occurred in random order and a visual cue signaled the next task to be performed. In the memory-based condition, the task alternated after every second trial in a predictable sequence without presenting a cue. The performance of bilinguals did not vary across experimental conditions, whereas monolinguals experienced a pronounced increase in response latencies and error rates in the cued condition. Both groups produced similar switch costs (difference in performance on switch trials as opposed to repeating trials within the mixed-task block) and mixing costs (difference in performance on repeat trials of a mixed-task block as opposed to trials of a single-task block), but bilinguals produced them with lower response latencies. The cognitive benefits of bilingualism seem not to apply to executive functions per se but to affect specific cognitive processes that involve task-relevant context processing. The present results suggest that lifelong bilingualism could promote in older adults a flexible adjustment to environmental cues, but only with increased task demands. However, due to the small sample size, the results should be interpreted with caution.
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Affiliation(s)
- Jennifer A Rieker
- Studies on Aging and Neurodegenerative Diseases Research Group, Madrid, Spain.,Department of Basic Psychology II, Facultad de Psicología, Universidad Nacional, Madrid, Spain
| | - José Manuel Reales
- Studies on Aging and Neurodegenerative Diseases Research Group, Madrid, Spain.,Department Methodology of Behavioral Sciences, Facultad de Psicología, Universidad Nacional de Educación a Distancia, Madrid, Spain
| | - Soledad Ballesteros
- Studies on Aging and Neurodegenerative Diseases Research Group, Madrid, Spain.,Department of Basic Psychology II, Facultad de Psicología, Universidad Nacional, Madrid, Spain
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17
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Beyond Alzheimer's disease: Can bilingualism be a more generalized protective factor in neurodegeneration? Neuropsychologia 2020; 147:107593. [PMID: 32882240 DOI: 10.1016/j.neuropsychologia.2020.107593] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2020] [Revised: 07/10/2020] [Accepted: 08/26/2020] [Indexed: 01/18/2023]
Abstract
Bilingualism has been argued to have an impact on cognition and brain structure. Effects have been reported across the lifespan: from healthy children to ageing adults, including clinical (ageing) populations. It has been argued that active bilingualism may significantly contribute to the delaying of the expression of Alzheimer's disease symptoms. If bilingualism plays an ameliorative role against the expression of neurodegeneration in dementia, it is possible that it could have similar effects for other neurodegenerative disorders, including Multiple Sclerosis, Parkinson's and Huntington's Diseases. To date, however, direct relevant evidence remains limited, not least because the necessary scientific motivations for investigating this with greater depth have not yet been fully articulated. Herein, we provide a roadmap that reviews the relevant literatures, highlighting potential links across neurodegenerative disorders and bilingualism more generally.
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18
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Individual Variation and the Bilingual Advantage-Factors that Modulate the Effect of Bilingualism on Cognitive Control and Cognitive Reserve. Behav Sci (Basel) 2019; 9:bs9120120. [PMID: 31766485 PMCID: PMC6960536 DOI: 10.3390/bs9120120] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2019] [Accepted: 11/16/2019] [Indexed: 12/18/2022] Open
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19
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van den Noort M, Vermeire K, Staudte H, Perriard B, Bosch P, Lim S. The Relationship Between Linguistic Ability, Multilingualism, and Dementia. J Alzheimers Dis 2019; 72:1041-1044. [PMID: 31683486 DOI: 10.3233/jad-190807] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
In a recent article of the Journal of Alzheimer's Disease, Hack et al. (2019) argue that linguistic ability rather than multilingualism is a significant predictor of dementia. In their longitudinal study, they investigated 325 religious sisters who were older than 75 years of age. Self-reports were used in order to determine multilingualism. They found that speaking two or three languages did not delay the onset of dementia. However, they did find that individuals speaking four or more languages were less likely to suffer from dementia than those speaking only one language and concluded that having linguistic ability was a more significant predictor of dementia than being multilingual. However, more research is needed in order to identify the characteristics of multilingualism most salient for the risk of dementia. In this commentary, we raise several important methodological and statistical issues that are likely to have affected the findings of Hack et al.'s study. As a result, although their study makes an important contribution to the research field, drawing a conclusion at this time that linguistic ability is more a predictor of dementia than multilingualism would be premature; moreover, their preliminary results cannot be generalized to the general population.
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Affiliation(s)
- Maurits van den Noort
- Kyung Hee University, Research Group of Pain and Neuroscience, Seoul, Republic of Korea
| | - Katrien Vermeire
- Department of Communication Sciences and Disorders, Long Island University, Brooklyn, NY, USA
| | - Heike Staudte
- Psychiatric Research Group, LVR-Klinik Bedburg-Hau, Bedburg-Hau, Germany
| | - Benoît Perriard
- Department of Medicine, Neurology, University of Fribourg, Fribourg, Switzerland
| | - Peggy Bosch
- Psychiatric Research Group, LVR-Klinik Bedburg-Hau, Bedburg-Hau, Germany.,Radboud University Nijmegen, Donders Institute for Brain, Cognition and Behaviour, Nijmegen, The Netherlands
| | - Sabina Lim
- Kyung Hee University, Research Group of Pain and Neuroscience, Seoul, Republic of Korea
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